Racial Trauma in Academia: Experiences of Black Women Counselor Educators

April D. Brown, LaShauna M. Dean, Matthew Lyons

This transcendental phenomenological study explored the lived experiences of Black women counselor educators mitigating experiences of racial trauma in the workplace. Bell’s critical race theory and Crenshaw’s intersectionality served as the frameworks for this study. Six participants were selected based on specific criteria: They held a PhD or EdD in counselor education and supervision, worked full-time in a CACREP-accredited program, were employed for at least 2 years, and self-reported that they experienced racial trauma in the workplace. Data collection involved semi-structured interviews, which were transcribed and analyzed for themes. Findings revealed the following textural themes: disrespect from colleagues and students, diminished well-being, lack of trust in competency, expressing concerns for safety/hypervigilance, a heightened awareness of intersectionality, awareness of social conditioning/exposure to sexualization, and the cognitive process. The final theme, surviving the environment, contributed to the structural description. Finally, the results provide implications for counselor educators, mental health professionals, and counselor education program administrators.

Keywords: racial trauma, Black women, counselor educators, workplace, transcendental phenomenological

 

The intersection of race and gender has long been a critical focal point in understanding the lived experiences of Black women, particularly in professional settings (Crenshaw, 1989). Black women occupy a unique space within the workforce, often navigating the compounded challenges of racism and sexism. These dual oppressions are pervasive and deeply ingrained in the structures of many workplaces, including counselor education. This study focuses on a central research question: What are the lived experiences of Black women counselor educators mitigating instances of racial trauma in the workplace? This article contributes to the body of literature that explores how Black women counselor educators experience oppression and racial trauma in the workplace.

Black women are disproportionately affected by workplace discrimination, and their experiences are often dismissed or minimized by colleagues and supervisors (Comas-Díaz et al., 2019; Williams, Printz, & DeLapp, 2018). Almost 92% of Black women reported racial discrimination in the workplace (Carter & Forsyth, 2010), which is compounded by a lack of representation of Black faculty within postsecondary institutions (National Center for Education Statistics [NCES], 2022). NCES (2022) found that among the 1.6 million faculty in degree-granting postsecondary institutions, Black women comprised 4% of full-time faculty. The 2024 Vital Statistics Survey of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) revealed that 18.27% of full-time faculty in CACREP-accredited programs identified as Black, whereas 61.16% identified as White (CACREP, 2025). However, there is a lack of research explaining how Black women faculty in counselor education perceive racial trauma in the workplace.

Mental Health and Racial Trauma
     Racism has detrimental effects on mental health and can cause psychological distress (Clark et al., 1999; Pieterse & Carter, 2007; Pieterse & Powell, 2016). Carter and Forsyth (2010) found that encounters with racism resulted in several harmful emotions, such as guilt, shame, anxiety, and hypervigilance. Other effects of racism include identity issues, internalization, isolation, aggression, substance abuse, domestic violence, race-related stressors, sexual promiscuity, and suicidal ideation, all of which can look different individually, institutionally/structurally, and culturally (Hemmings & Evans, 2018; Pieterse & Powell, 2016).

There is a pressing need to address the effects of racism in all settings, as Black women experience more mental health problems than other racial groups (Allen et al., 2019; Catabay et al., 2019). Black women experience not only individual racism, but also institutional or structural racism, which can lead to health disparities (Holder et al., 2015; Jones, 1997; Knighton et al., 2022; Pieterse & Powell, 2016; Sotero, 2006). Workplace hostility can cause severe traumatic stress, including increased anxiety, depression, hypervigilance, avoidant reactions, and other poor mental health outcomes (Carter & Forsyth, 2010; Dickens & Chavez, 2018; Loo, 2003; Shih et al., 2013; Triana et al., 2015; Williams, Printz, & DeLapp, 2018).

Racial trauma is “a form of race-based stress referring to people of color and Indigenous individuals’ reactions to real or perceived experiences of racial discrimination” (Comas-Díaz et al., 2019, p. 1). Racial trauma results from overt acts of racial hostility and subtle, insidious forms of racism, such as microaggressions or the pressure of having to conform to predominantly White workplaces. For Black women counselor educators, instances of racism include racialized marginalization, pressure to prove their competence, and invalidation of their experiences (Haskins et al., 2016; Pérez & Carney, 2018). The cumulative effect of these experiences can lead to chronic stress, anxiety, depression, and other mental health challenges, which are exacerbated by the intersectional nature of Black women’s identities (Arday, 2022; Bernard et al., 2017; Crenshaw, 1989; Pieterse & Powell, 2016; Pizarro & Kohli, 2020).

Due to racialized and gendered microaggressions, Black women faculty might feel racial battle fatigue (Behar-Horenstein et al., 2012; Chancellor, 2019), which is often made worse by the Strong Black Woman schema, a cultural expectation for Black women to exhibit resilience in the face of adversity (Castelin & White, 2022; Liao et al., 2019). Similar to the effects of racial trauma, the Strong Black Woman schema can cause adverse psychological effects (Castelin & White, 2022; Liao et al., 2019). While this stereotype may serve as a coping mechanism, it can also discourage Black women from seeking mental health support, leading to a reluctance to acknowledge or address the psychological harm they endure.

Racial Trauma in the Workplace
     Because Black women are more susceptible to mental health concerns, exploring their lived racial trauma experiences in counselor education programs could provide insight into the associated mental health outcomes (Carter & Forsyth, 2010). Research supports that many Black women experience ongoing workplace discrimination (Dickens & Chavez, 2018; Holder et al., 2015; Shih et al., 2013; Velez et al., 2018). For Black faculty, racial trauma negatively impacts job satisfaction (DeCuir-Gunby & Gunby, 2016). Black women frequently feel the need to identity-shift or alter their cultural behavior, often through code-switching, causing psychological distress (Dickens & Chavez, 2018; Fields & Cunningham-Williams, 2021; Shih et al., 2013). Unfortunately, these changes do not always prevent adverse outcomes (O’Brien et al., 2016).

There is an unfulfilled need to discuss and address racial trauma in the workplace. While there are promising clinical approaches, such as race-based therapy (Bryant-Davis & Ocampo, 2006), racial trauma recovery (Comas-Díaz, 2016), feminist therapy (Brown, 2008), and trauma-focused cognitive behavioral therapy (TF-CBT; Phipps & Thorne, 2019), there are no empirically supported treatments for racial trauma (Comas-Díaz, 2016; Williams et al., 2018a). This research seeks to investigate how Black women faculty conceptualize and interpret the impact of racial trauma in academia, aiming to elucidate the nuanced meanings and implications.

Methods

The central research question guiding this study was: What are the lived experiences of Black women counselor educators mitigating instances of racial trauma in the workplace? This question was explored using Moustakas’s (1994) transcendental phenomenological design. Transcendental phenomenology allows the researcher to understand the natural essence of the phenomenon through intentionality and intuition (Descartes, 1977; Husserl, 1999). The researchers captured the essence of each participant’s experience by constructing textural descriptions of what the participants experienced and how they experienced it (Moustakas, 1994), which were constructed into composite textural and structural descriptions.

Research Positionality
     Three authors are involved in this study, and before discussing our results, we want to acknowledge our positionality in relation to this research. The first author, April D. Brown, originally developed this study for her doctoral dissertation. She is an African American cisgender woman and a practicing counselor who acknowledges experiencing racial trauma. As a licensed professional counselor, Brown has worked closely with clients who experienced racism and discrimination in the workplace. She also encountered her own internalized racism and experienced vicarious trauma as she listened to participant stories. She attended therapy, engaged in reflective meditation repeatedly, and consulted a peer reviewer to ensure objectivity in this study.

The second author, LaShauna M. Dean, is an African American cisgender woman who has been a faculty member in counselor education for 12 years. She recognizes that her social position may influence her interpretation of participant narratives, given her experiences as a Black faculty member. Dean has a strong commitment to accurately conveying participants’ stories, as she recognizes the potential benefits of addressing racial trauma in counselor education and has reflected on her own biases through the research process by engaging in critical self-reflection.

The third author, Matthew Lyons, is a White cisgender male counselor educator and academic administrator. Diversity is a significant part of his personal and professional priorities. Lyons acknowledges the ever-present reality of racism and the importance of sharing stories of racial trauma. He was the chair of the dissertation committee for Brown and, therefore, involved in this research from the early stages.

Recruitment and Participants
     All participants in this study were Black women counselor educators employed as full-time faculty in CACREP-accredited programs. Researchers recruited participants by first utilizing the CACREP directory to send emails to faculty, secondly by posting the recruitment flyer in the Facebook group for the Association for Multicultural Counseling and Development, and lastly by posting study details on the CESNET-L listserv. Each recruitment attempt included a description of the study, the interest and inclusion survey to verify eligibility and the contact information of the primary researcher. Eligible participants self-identified as a Black woman, held a terminal degree in counselor education and supervision, had at least 2 years of faculty experience, and self-reported experiencing racial trauma. Participants were provided with the Comas-Díaz et al. (2019) definition of racial trauma and responded “yes” or “no” to whether their experiences met the definition. Six participants met all recruitment criteria, including availability for the interview. One participant did not disclose gender pronouns and is referred to using gender-neutral pronouns (they/them) in this manuscript. Participants’ demographics and pseudonyms are presented in Table 1.

Table 1

Participants’ Demographic Characteristics

Participants Amber August Hazel June May Summer
Age 25–40 41–56 25–40 25–40 41–56 25–40
Gender pronouns She/her/

hers

She/her/ hers Prefer not

to say

She/her/ hers She/her/ hers She/her/ hers
ACES region NCACES SACES SACES NCACES SACES SACES
State of residence MN AL MD WI LA TN
Years of experience 6–10 11–14 2–5 2–5 2–5 6–10

Note. ACES = Association for Counselor Education and Supervision; NCACES = North Central Association for Counselor Education and Supervision; SACES = Southern Association for Counselor Education and Supervision. Regional classifications are based on the five ACES regions (ACES, 2021).

Data Collection
     Semi-structured interviews, lasting approximately 60 minutes, served as the primary source of data. The interview protocol included questions about experiences of racial trauma as well as supports that mitigated those experiences (see Appendix). The interview protocol was developed to address identified gaps in the literature around workplace trauma explicitly experienced by Black women in counselor education and was aligned with the principles of transcendental phenomenology.

Data Analysis
     Data analysis followed the eight-step process outlined by Moustakas (1994), which involves a systematic and reflective approach to understanding lived experiences. Our research team began by transcribing interviews and engaging in horizontalization, identifying all relevant statements with equal value. Through reduction and elimination, nonessential or overlapping data were removed, and significant expressions were distilled into invariant constituents, which were then clustered into core themes. We then verified the relevance of these themes in the final identification phase to ensure they authentically reflect participants’ experiences. Using these themes, we constructed individual textural descriptions (what was experienced) and structural descriptions (how it was experienced). These were then synthesized into textural–structural descriptions to capture the full essence of each participant’s experience. Finally, these insights were integrated into a composite description that represents the collective meaning and essence of the phenomenon across all participants, ensuring both depth and rigor in capturing the lived experience.

Interviews were conducted via Microsoft Teams video calls and transcribed using Rev, a transcription service. Following transcription via Rev (n.d.), the interview data were analyzed using Delve (n.d.), a cloud-based qualitative data analysis platform designed to support rigorous thematic analysis. Delve assisted the researchers in systematically coding, clustering, color-coding, and visually mapping qualitative data to identify patterns and themes across transcripts. This process facilitated an iterative and structured approach to data analysis consistent with phenomenological methodology. Delve and Rev comply with General Data Protection Regulation standards, ensuring participant confidentiality and the secure handling of sensitive data throughout transcription and analysis (Delve, 2022; Rev, n.d.). Upon completing the data analysis process, each participant received copies of the constructed descriptions from their interviews to provide feedback in alignment with member checking procedures.

Trustworthiness
     Several methods were employed to ensure trustworthiness during the study’s interview and data analysis portions. First, Brown used a detailed field log and reflexive journal to record decisions and processes throughout the research, which facilitated self-reflection and enhanced self-awareness throughout the research process. The journal documented thought processes and supported data interpretation (Silver & Lewins, 2014; Tobin & Begley, 2004).

Member checking was also used to ensure trustworthiness by sending participants their textural–structural descriptions after the interview. Participants could confirm or modify their descriptions in writing to ensure that they accurately reflected their experiences (Humphrey, 1991; Moustakas, 1994), and this feedback was used to make adjustments. For unresponsive participants, Humphrey (1991) suggested that their descriptions should reflect the researchers’ interpretation of the data.

Finally, an independent peer reviewer participated in the data analysis to confirm the findings and served as a sounding board to ensure objectivity throughout the research. The peer reviewer had experience conducting phenomenological research. Brown met with the peer reviewer three times to discuss the data analysis process, during which they reviewed the initial list of themes, reviewed the reduction and elimination process, identified core themes, and incorporated the relevant information into the study. All participants were aware of the peer reviewer’s role from the informed consent form.

Results

This transcendental phenomenological study explored the lived experiences of Black women counselor educators and their experiences of racial trauma in the workplace to highlight ways in which they navigated those experiences. Our results indicated that the experiences of Black women counselor educators were unique to their individual contexts and settings. The following themes emerged from our data: 1) disrespect from colleagues and students, 2) diminished well-being, 3) lack of trust in competency, 4) expressing concerns for safety/hypervigilance, 5) heightened awareness of intersectionality, 6) awareness of social conditioning/exposure to sexualization, 7) the cognitive process (i.e., how racial trauma experiences impacted their thought process), and 8) surviving the environment.

Theme 1: Disrespect From Colleagues and Students
     While discussing their experiences of racial trauma in the workplace, the participants described navigating disrespect from colleagues and students, such as name-calling, retaliation, microaggressions, and professional demotions (e.g., not being addressed by their professional titles or credentials). For Hazel, experiencing disrespect in predominantly White institutions was a “reality check.” They stated, “[In the] field of counseling and psychology . . . as a counselor educator, you will be called by your first name. You’ll be demoted by students, by faculty, by colleagues, by everyone.” They recalled, “I’ve gotten emails from students, ‘Hey, can you change [something]?’” August stated, “One student . . . didn’t get the A she thought she [would], and she stopped speaking to me.” She recalled another incident, stating, “I had another student [who] was like, ‘All you talk about is race.’” She also recalls being told, “I am the worst teacher.”

Theme 2: Diminished Well-being
     Participants expressed diminished well-being while navigating racial trauma at work. May described experiencing significant physical and psychological distress as well as social–emotional concerns, noting an unintentional 77-pound weight loss, disrupted sleep, diminished appetite, and medical issues such as elevated blood pressure, along with cognitive distortions and heightened perfectionistic tendencies. She explained:

My presentation changed, and [there were] rumors. I’ve gained the weight back, but I had lost a lot of weight rapidly, and I had started to become more isolated and closed-off and cryptic. So, some folks were like, “Your personality went from bubbly to more withdrawn.”

August also expressed how racial trauma affected her well-being. She noted that she was diagnosed with pneumonia, an autoimmune disorder, and shingles while navigating racial trauma at work. She stated, “Long story, it’s not really short, but health. Health was the main thing that [racial trauma] really impacted. And mental health as well.”

Theme 3: Lack of Trust in Competency
     Lack of trust in competency was a key theme that emerged from the participants’ experiences. While most participants described experiencing a lack of trust in competency in previous workplaces, one participant, June, was actively facing it in her current workplace. Her experience provides a critical perspective on how racial trauma manifests in real time. She recalled:

[The students would] ask me a question, and I’d respond. Then they’d look it up and be like, “Well, actually, dah, dah, dah.” Or I’d give them a response; they’d run to someone else and be just doing all this stuff. Or one group, they do an exit survey and stuff. They just ripped into every class that was specific to what I taught. No grace of, “Oh, it’s your first time teaching.”

June perceived a lack of trust in her competency as an ongoing issue in the workplace. She explained, “It was a reminder of, no matter what, it doesn’t matter if I’m super competent or know what I’m talking about, there’s always going to be people questioning every last thing I tell them.”

Theme 4: Expressing Concerns for Safety/Hypervigilance
     June expressed concerns for safety while actively navigating experiences of racial trauma. Unlike other participants, who had processed their experiences after leaving harmful workplaces, June was currently navigating a series of traumatic incidents. She was “fearful of things,” displayed hypervigilance, and frequently assessed potential threats at work. The first incident occurred when a magazine published content criticizing her work. She stated, “That moment was just like, whoa. There’s a lot of fear with that.”

After the incident, June expressed concerns for her safety by not wanting to put her location on her institution’s website. She stated, “I don’t want to make it easier for people to find me. I know they can find me if they really want to.” Her fears extended to food delivery. She explained, “Oh, my gosh. You never know who’s going to deliver [the food]. What if they recognize my name and want to harm me in some way, or what if I come on campus and something happens?” June worried about her safety returning to work in person during the COVID-19 pandemic. She described attending the “first all-college meeting” at her predominantly White institution and how she felt being the only Black person in the room. She stated, “Actually, it was kind of overwhelming because I was like, ‘We’re all in this room. I don’t like it.’” June recalled walking to class when she saw a van approaching her slowly. She stated, “The windows rolled down, and they yelled, ‘“Trump 2020’ or something.” She explained:

It was jarring because I wasn’t expecting that to happen. Then they drove off. I remember feeling so disoriented that I’ve been walking to class this whole time, that I started to, in a way, get lost, not remember where my classroom was, just because I was still in disbelief. I’m like, “It’s broad daylight.”

After these incidents, June took measures to protect herself. She stated, “I ended up buying a key chain. I forgot what it’s called, but it’s a little metal thing that I guess, worst-case scenario, you just jab someone with it, right, but it’s not sharp or anything.”

Theme 5: Heightened Awareness of Intersectionality
     Participants experienced a heightened awareness of intersectionality, recognizing that their intersections of race and gender impacted their workplace experiences. For participants, navigating these intersections in the workplace was the norm, something to be expected. August explained that in counselor education, “You’re the unicorn—you’re just unusual.” For Summer, navigating race and gender required a constant attunement to self-awareness. She stated, “It’s a constant knowing. It’s a constant double consciousness. I have to think about how other people are experiencing me [and] how I’m experiencing the situation. Also, [I’m] thinking about how I’m showing up in these particular environments.” Similarly, Amber shared, “I am very cognizant that I have a worldview and a perspective unique to being a Black woman.” She also said that navigating race and gender “takes a little bit of work,” including “learning how to do some compartmentalizing with my identity.”

Theme 6: Awareness of Social Conditioning/Exposure to Sexualization
     Awareness of social conditioning/exposure to sexualization described participants’ awareness of society’s assumptions of Black women and of being sexualized at work. Our participants believed that preconceived notions such as societal assumptions, stereotypes, and expectations for Black women exacerbated their racial trauma experiences. Summer reflected on how societal stereotypes prevent Black women from being seen as whole individuals. She noted that Black women are often perceived as strong, emotionless, or lacking intellectual credibility, leaving little room for their full humanity to be acknowledged. Consequently, she believed that her identity contributed to colleagues dismissing her experiences of racial trauma in the workplace.

June said, “I think it’s interesting because, on one hand, I feel like Black women are always kind of seen as strong, right, and scary, and angry, and whatever.” August’s awareness of social conditioning meant managing work and caregiving responsibilities. She mentioned, “Sometimes, it gets very stressful being a woman and being that nurturing person because that’s what is expected of me.” August believed that Black women are socialized to do it all. She explained:

I have to, in a sense, be a liaison for adjunct professors and everything. I’m doing all of this, I’m teaching, and I was trying to publish so I wouldn’t perish, going to conferences, and taking care of my mom. I was juggling [everything].

Participants were sexualized at work by colleagues and students. Summer perceived being sexualized by her colleagues as a form of name-calling. She stated, “I’d gotten an award for something, and someone said [I received the award] because my boss had jungle fever, [not] because of my expertise or my knowledge. They thought it was a joke.” Summer found the joke inappropriate, stating it “sexualized” her. She also felt “ostracized” and “traumatized.” In contrast, May experienced sexual harassment from a student. She recalled feeling stunned and in disbelief, noting that she never expected a student to address her in such a sexualized manner or to encounter this kind of harassment in a professional setting.

May attributed her experience to her identity. She noted that Black women are oversexualized in the media. As a result of her experience, she adjusted her appearance and behavior to reclaim her sense of agency and reduce unwanted attention. She stated:

At one point, I thought I was becoming the asexual mammy archetype because I was becoming more coddling, more docile, and more, whatever you say, let’s go with the flow. I remember how my dress had changed. I started wearing [what] I call the deaconess buns, like the braided buns, after the situation. I wouldn’t put on nothing but chapstick, and I would dress down. But the outfits I was picking were like those floral-pattern, shapeless [dresses] so you couldn’t see a single curve.

Theme 7: The Cognitive Process
     The participants described how their racial trauma experiences impacted their thought processes. May initially felt unsupported at her institution. She explained, “Being a Black woman in academia, in the beginning, it was very lonely, isolating, and tokenized for me for [the] years 2018, 2019, [and] 2020.” May’s perspective shifted when her department hired another Black woman. She stated, “I immediately felt the love; it was the missing component.”

June believed that her racial identity made her more susceptible to racial discrimination. She stated, “I know that it’s always going to be a thing because there’s always going to be students coming in who have never encountered a Black woman in a role like this.” She also viewed racial trauma as inevitable at a predominantly White institution. She explained:

I think, in some ways, I kind of expected to run into some stuff. In some ways, I maybe thought it might have been a little bit [worse], actually. I think that’s just having an awareness of, “Yeah, I’m entering a predominantly White environment.”

June perceived the incidents she experienced on campus as intense, which left her feeling threatened and intimidated.

Hazel expressed a mistrust of the institution. They refused to teach a course again after the administration withheld pertinent information about a student in their class. They stated, “I don’t trust the admin to be protective or to keep me safe. Yeah, the mistrust is definitely there.” Hazel became suspicious and questioned joining professional organizations and the integrity of the profession as a whole. They explained, “[Racial trauma] made me question my field, question my counterparts, and wonder, ‘How are we really helping?’”

Theme 8: Surviving the Environment
     Participants employed various strategies to reduce the impact of racial trauma in the workplace and maintain well-being. Many relied on spiritual and therapeutic practices. Summer shared that her “church family” provided support, and her spirituality increased as she navigated racial trauma. May echoed, “My church, my God, [and] my higher power [helped me cope].” Participants also used therapeutic resources. Summer stated, “For my mental health and well-being, I went to counseling.” May found individual therapy and coaching helpful, August benefited from group therapy, and June engaged in the sandplay process. August and Summer also found journaling beneficial. Similarly, Amber relied on self-awareness and shared, “The more I understand about myself . . . the better I’m able to navigate.” August found that “using [her] senses to ground [her]” was highly beneficial.

Community support was another key strategy. Amber noted, “I think it’s really important to have support, to not try to address it alone.” Summer emphasized “a positive support group, an affinity group . . . committed to actionable steps to help you navigate a racist academy.” May similarly highlighted the importance of forming “a united front” with colleagues. June’s relationships with marginalized colleagues created spaces to process, “support each other,” and have “all kinds of conversations.” She also found connecting with students “exciting” and meaningful.

Some participants coped by giving back to the community. June felt responsible for Black students, drawing on the concept of “other mothering” and expressing a desire to nurture and look out for students facing racism. Hazel continued working at an institution where they experienced racial trauma because they were committed to supporting a Black student. They stated, “I’m on a student’s dissertation. . . . She’s an African American student, and I really want to support her. I’m trying to hang in there.”

Participants also found relief through intentional diversity, equity, and inclusion (DEI) efforts. June routinely incorporated multiculturalism, equity, and social justice into her courses. She shared, “I tell students about [racial battle fatigue]. I find any reason to bring it up at least once.” She noted, “It gives you hope so that it’s healing in that way.” Summer similarly infused Ratts et al.’s Multicultural and Social Justice Counseling Competencies (MSJCC; 2015) across her program, explaining that diversity was present “not [in] just one day of the schedule but [in] every conversation we’re having.” Amber, as program chair, remained committed to promoting DEI and relied on a “social justice lens” to review policies and ensure equity.

Several participants turned to counseling literature as a coping strategy. Hazel described using exercises from The Racial Healing Handbook by Anneliese Singh and referencing Jennifer Fraser’s work on workplace bullying. May accessed the MSJCC and the work of scholars such as Derald Wing Sue, David Sue, Cirecie West-Olatunji, Kent Butler, and writers like Gwendolyn Brooks, bell hooks, and Patricia Collins.

Overall, participants’ coping strategies reflected key relational dimensions: self, others, space, and time. August’s and Amber’s focus on self-advocacy, self-awareness, and self-care fostered resilience. June and Summer emphasized relationality through peer and student connections. Spatial awareness informed decisions to leave unsafe environments, as seen in Hazel’s and Summer’s stories. May’s experience highlighted time as a resource that required boundaries and intentional management. Together, these strategies demonstrate the multidimensional ways Black women in counselor education coped with and made meaning of their racial trauma experiences.

Discussion

This transcendental phenomenological study explored Black women counselor educators’ lived experiences of racial trauma in the workplace, and our results indicate that those experiences of racial trauma were unique to the participants’ contexts and settings. The participants perceived their experiences of racial trauma in the workplace as a larger systemic issue that was beyond their control, supporting the idea that racial inequality results from institutional and structural factors rather than individual prejudice (Reece, 2018). Previous research has explored racial microaggressions in the workplace, racism on college campuses, racial battle fatigue among educators, and microaggressions among female faculty (Avent Harris et al., 2019; Blackshear & Hollis, 2021; Pérez & Carney, 2018; Rollock, 2021). Past research also indicated that Black women faculty in predominantly White institutions frequently experience microaggressions from students, colleagues, and staff (Blackshear
& Hollis, 2021).

Our study provided new insight into Black women counselor educators’ perspectives on their racial trauma experiences in the workplace. Participants described disrespect from colleagues and students, including microaggressions, name-calling, retaliation, and professional demotions that indicated being devalued in their professional roles. Participants also described feeling several negative emotions, such as hurt, frustration, and outrage, while navigating racial trauma in the workplace (Carter & Forsyth, 2010). As outlined in previous research (Anderson, 2012; Bernard et al., 2017; Carter & Forsyth, 2010; Pieterse & Powell, 2016), our participants confirmed that race-related stress resulted in physical and mental health challenges, which aligns with previous studies that link the prevalence of racism to ailments among people of color (Allen et al., 2019; Alvarez et al., 2016; Catabay et al., 2019; Loo, 2003; Williams et al., 2018) and the detrimental impact of workplace discrimination on overall well-being (Dickens & Chavez, 2018; Knighton et al., 2022; Shih et al., 2013; Triana et al., 2015). Black women often feel compelled to prove their competence and credibility to colleagues and students, particularly White colleagues (Haskins et al., 2016; Kelly et al., 2017; Pérez & Carney, 2018). Our study revealed that a lack of trust in competency was an ongoing issue for a participant working in a predominantly White setting. Results suggest that students primarily questioned and challenged this participant’s competence.

Participants expressed concerns about their physical and psychological safety, with a participant describing the need to protect herself after experiencing a series of traumatic incidents on campus. Two participants left the institutions where they experienced racial trauma to find safer work environments. This finding suggests that emphasizing the “E” stage (enhancing safety) within the TF-CBT PRACTICE framework may help reduce the impact of racial trauma (Metzger et al., 2020). Therefore, counselor education program administrators might focus on prioritizing psychological safety in the workplace to reduce racial trauma experiences among Black women counselor educators.

Participants knew their social locations, societal stereotypes, and assumptions negatively impacted their roles in the workplace and believed preconceived notions influenced their experiences of racial trauma. They were aware of the intersectionality of racism and sexism (Crenshaw, 1989), which they believed increased their susceptibility to workplace racism (Avent Harris et al., 2019; Behar-Horenstein et al., 2012; Chancellor, 2019; Rollock, 2021).

Past research showed that Black women encounter racism and sexism in higher education (Behar-Horenstein et al., 2012). Our participants described experiences of sexual harassment by colleagues and students, indicating that their intersecting identities exacerbated their racial trauma experiences. Participants’ heightened awareness of intersectionality developed as they navigated the complexities of race and gender in their workplace (Bell, 1995; Delgado & Stefancic, 2017). Their deep understanding of intersectionality, shaped by lived experiences of oppression at the intersection of race and gender, underscores the need for deeper exploration of the unique perspectives and worldviews that emerge from navigating these systemic barriers.

In alignment with previous research finding that Black faculty experience daily microaggressions in the workplace and feelings of victimization (Arday, 2022), our participants described feeling excluded and isolated within their institutions as they navigated the workplace alone. These experiences are consistent with previous research  highlighting the challenges that marginalized faculty face in counselor education (Haskins et al., 2016; Pérez & Carney, 2018). Another participant perceived her experiences of racial discrimination as inevitable, supporting past research that Black tenured faculty reported and expected racism in institutions (Blackshear & Hollis, 2021), while mistrusting the institution involved, feeling suspicious, and lacking confidence in the work environment. This finding supports previous literature that documents suspiciousness as a psychological effect of racial trauma (Bryant-Davis & Ocampo, 2006; Comas-Díaz et al., 2019). Our study’s results indicate that cognitively processing racial trauma experiences was an emotional release for participants.

Amidst their challenges, our participants navigated and processed racial trauma in distinct and deeply personal ways, reflecting varied coping strategies and resilience. Participants discussed how they employed several internal and external coping strategies to reduce the impact of racial trauma. The coping strategies described by participants parallel previous recommendations for addressing racial trauma, including Black women’s reliance on internal resources for coping (Stevens-Watkins et al., 2014), community support (Chioneso et al., 2020; Liu & Modir, 2020), and integrating relaxation techniques (Metzger et al., 2020).

Past research found that Black women and people of color are less likely to seek mental health services (Stevens-Watkins et al., 2014) and support for stress and racism (Carter & Forsyth, 2010); however, our study participants sought counseling to cope with their experiences. Two participants left their institutions when they felt unsafe, confirming that racism negatively impacts job retention and well-being (Pizarro & Kohli, 2020). Participants focused on DEI work as a strategy for coping, explicitly advocating for faculty diversity to reduce racial trauma experiences. Our study revealed that participants used counseling literature to cope and unknowingly applied Ratts et al.’s (2015) MSJCC advocacy domains. Despite this, study participants did not consciously consider using the MSJCC to address workplace issues such as racial trauma. This finding supports the recommendations of previous scholars to fully operationalize the MSJCC (Hays, 2020; Singh et al., 2020).

Implications for the Profession
     This study has implications for Black women counselor educators experiencing racial trauma in the workplace, mental health professionals supporting clients facing racial trauma, and counselor education program administrators who supervise Black women faculty and implement policies affecting their work. Black women counselor educators must consider how systemic issues contribute to their workplace experiences and overall well-being. Mental health professionals working with clients who may be experiencing racial trauma should identify and screen for racial trauma, use culturally relevant interventions and racial models of recovery to treat racial trauma, utilize cognitive and behavioral strategies that promote relaxation, and help clients identify internal and external resources for coping.

Mental health professionals also have a responsibility to address issues related to oppression, privilege, and social inequities (Lee, 2007). When working with Black women counselor educators, mental health professionals should be aware of anti-DEI policies and legislation while empowering clients to engage in social justice and advocacy to reduce racial trauma at work. As DEI programs are no longer permitted within federal government agencies (The White House, 2025), implications for counselor education program administrators include recognizing the impact of anti-DEI mandates, policies, programs, and activities on counselor education programs. Administrators should inform counselor educators, staff, and students about how these changes impact employment, hiring practices, workplace policies and procedures, and curriculum. Although recent executive orders emphasize advancing a policy of equal dignity and respect (The White House, 2025), counselor education administrators should consider strategies to foster a workplace culture that upholds federal civil rights protections for all employees. They should also familiarize themselves with anti-discrimination laws and focus on enhancing psychological safety and support to reduce the impact of racial trauma in counselor education programs.

Limitations
     Our recruitment strategy limited our sample size due to the criteria we set and the sensitive nature of the research topic, which consequently restricts the transferability of our findings. Our sample size also lacks racial and gender diversity, with all participants identifying as Black women. Black people experience racial trauma more than any other racial group (Comas-Díaz et al., 2019; Williams, Printz, & DeLapp, 2018). However, the exclusion of male participants is a limitation, and understanding Black men’s experiences as counselor educators is also worth exploring in depth.

Finally, bracketing personal experiences in phenomenological research is difficult because researchers always bring their own assumptions to the study (Moustakas, 1994; van Manen, 1990, 2014). Hence, our interpretation of the data could reflect our biases, beliefs, and values. Because all of us have counselor educator experience, our professional experiences may have shaped our interpretation of participants’ experiences. Therefore, we took intentional steps to minimize our biases and bracket our experiences, including journaling, member checking, and peer review throughout the research process.

Conclusion

This study aimed to explore Black women counselor educators’ lived experiences of racial trauma in the workplace. The findings showed that the participants had experiences unique to their contexts and settings. Participants experienced significant challenges, including disrespect from colleagues and students, diminished well-being, a lack of trust in their competency, expressing concerns for safety/hypervigilance, a heightened awareness of intersectionality, an awareness of social conditioning/exposure to sexualization, and the cognitive process. Despite these hardships, they employed various coping strategies to survive the environment, thus mitigating racial trauma in the workplace. This study contributes essential knowledge to counselor education by highlighting the systemic conditions that shape the experiences of Black women counselor educators and revealing a critical need for structural and institutional change to ensure safe, equitable, and culturally responsive environments that support the well-being and professional longevity of Black women faculty.

 

Conflict of Interest and Funding Disclosure
Data collected and content shared in this article

were part of a dissertation study, which was
awarded the 2024 Dissertation Excellence Award
in Qualitative Research by The Professional Counselor
and the National Board for Certified Counselors.

 

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April D. Brown, PhD, NCC, CPCS, LPC, is a licensed professional counselor at The Wellness Room LLC. LaShauna M. Dean, PhD, NCC, ACS, LPC, is an associate professor at University of the Cumberlands. Matthew Lyons, PhD, is a professor and dean at University of the Cumberlands. Correspondence may be addressed to April D. Brown, 2870 Peachtree Rd NW Suite 915-8596, Atlanta, GA 30305,  info@trythewellnessroom.com.

 

Appendix

Interview Protocol

  1. What does it mean to be a Black woman counselor educator?
  2. Tell me about your experiences working as a Black woman counselor educator.
  3. Tell me about the racial trauma you have experienced in the workplace.
    1. What was it like for you? How did these experiences impact you?
  4. Tell me what areas in your life were most impacted due to these experiences.
  5. How would you describe the role that race and gender played in these experiences?
  6. Let’s talk about what you have done to mitigate experiences of racial trauma in the workplace.
    1. How would you describe the intentional choices you made to deal with these experiences?
    2. What specific actions did you take?
    3. What specific interventions helped you overcome these experiences?
  7. Tell me, was there anything from the counseling literature that helped you?
    1. What about the Multicultural Social Justice Counseling Competencies?
  8. Tell me who was a part of your work experience and helped you overcome racial trauma in the workplace.
  9. What external factors helped you overcome these experiences?
  10. As you reflect on your experiences, is there anything else you want me to know about your experiences mitigating racial trauma in the workplace?

Counselors and Workplace Wellness Programs: A Conceptual Model

Yvette Saliba, Sejal Barden

Occupational stress is a top source of stress for over 65% of Americans due to extended hours in the workplace. Recent changes in health care have encouraged employers to build workplace wellness programs to improve physical and mental health for employees to mitigate the effects of occupational stress. Wellness programs focus on either disease management; treating chronic illnesses, such as hypertension and diabetes; lifestyle management; or preventing chronic illnesses through health promotion. This manuscript provides an overview of recent changes in health care and describes a conceptual framework, Steps to Better Health (S2BH), that counselors can use in workplace wellness programs. S2BH is an 8-week psychoeducational group based on the combination of motivational interviewing (MI) and the transtheoretical model of change (TTM).

 

Keywords: wellness, health care, workplace, stress, Steps to Better Health

 

Health and wellness are two concepts that have captured the attention of people throughout history. From Greek mythology to modern times, the idea of well-being has permeated society (Myers & Sweeney, 2007). Today, with the Patient Protection and Affordable Care Act (PPACA), health care is moving away from a disease treatment model and embracing a disease prevention model (PPACA, 2010). Although individuals typically do not invest in preventive health measures, many businesses and companies are eager to improve their health care programs for employees (Willis Towers Watson, 2017). These changes in health care are relevant to mental health providers, as a new focus on prevention has created opportunities for counselors to help effect lasting health changes among employees. Therefore, to fit into this paradigm shift, professional counseling should be strongly connected to prevention and wellness (Granello, 2013). This article discusses the changes in health care models, how those changes are creating spaces for mental health counselors to fill and implications for the counseling profession.

 

The Changing Landscape of Health Care

In 2015, the Kaiser Family Foundation released a report highlighting the rising cost of health care expenditures from 1960 to 2013. This report indicated that health care costs, which include total costs for hospital visits, physicians and clinics, as well as prescription medications, have risen from 27.4 billion dollars to over $2 trillion (Kaiser Family Foundation, 2015). Due in part to increases in the cost of health care and health insurance, the PPACA was passed into federal law in 2010. Mandates of the PPACA include: (a) preventing the denial of coverage for pre-existing conditions; (b) strengthening community health centers; (c) decreasing health disparities; (d) promoting integrated health systems; (e) connecting physician payments to the quality rather than the quantity of care provided; and (f) lowering long-term costs by providing free and more comprehensive preventive care (U.S. Department of Health and Human Services, Health Care, 2016). In a White House memo sent out during National Public Health Week in 2014, President Obama stated, “my administration is supporting efforts across our country to improve public health and shift the focus from sickness and disease to wellness and prevention” (Obama, 2014, p. 1).

This shift is clearly seen in the PPACA. Section 4001 of the PPACA, entitled “Modernizing Disease Prevention and Public Health Systems,” discusses ways in which health prevention should be carried out within the public sector (PPACA, 2010). This portion of the law includes a taskforce team that would: (a) evaluate wellness programs in 2013; (b) create the Prevention and Public Health Fund to distribute money to worksites establishing wellness programs; (c) further the education of health and wellness promotion; and (d) report on measures enacted that address lifestyle behavior modification (PPACA, 2010). Lifestyle behavior modification is defined as activities that include “smoking cessation, proper nutrition, appropriate exercise, mental health, behavioral health, substance use disorder, and domestic violence screenings” (PPACA, 2010, p. 422). In other words, initiatives from the federal government highlight the emphasis on prevention in both community and clinical health venues and extend this focus by supporting research into workplace wellness initiatives (Anderko et al., 2012). Though the PPACA encourages workplace wellness programs, many employers see the benefits to their employees even without federal regulations. In a recent survey, employers indicated they are still committed to better workplace wellness programs despite the unknown future of the PPACA (Willis Towers Watson, 2017). One primary motivator behind these programs is a reduction of employee stress through health promotion.

 

Health Promotion in the Workplace

According to the 2015 Bureau of Labor and Statistics report, Americans spent 8.8 hours a day at work or doing work-related activities (U.S. Department of Labor, 2016). Therefore, it can be estimated that Americans spend much of their lives in workplace settings, which can lead to occupation-related stress. In 2012, the American Psychological Association’s (APA) Stress in America Survey revealed that 65% of Americans reported work as a top source of stress (APA, 2016). Stress can affect a person’s emotional state, and it also can weaken the body’s ability to regulate itself after a stressful experience, which can eventually cause detrimental health consequences (Galla, O’Reilly, Kitil, Smalley, & Black, 2015). For example, the effects of chronic stress have been shown to lead to obesity and metabolic diseases (Razzoli & Bartolomucci, 2016). As a result, many individuals have resorted to maladaptive ways of coping with stress, highlighting the need for bringing stress management skills to the workplace (Galla et al., 2015). In addition, the World Health Organization has stated that health promotion in the workplace (promoting aspects of physical and emotional wellness) is beneficial in combating work-related stress (Jarman, Martin, Venn, Otahal, & Sanderson, 2015).

Finding ways to help employees manage their stress through health promotion in the workplace is typically conducted through workplace wellness programs, which include both lifestyle and disease management programs (Caloyeras, Hangsheng, Exum, Broderick, & Mattke, 2014; Kaspin, Gorman, & Miller, 2013; Mattke et al., 2013). Promoting positive health habits among employees maintains affordable health coverage and increases worker productivity (Anderko et al., 2012; Parkinson, Peele, Keyser, Liu, & Doyle, 2014; Shapiro & Moseley, 2013). Most workplace wellness programs focus on disease management, treating chronic illnesses such as diabetes and hypertension. Disease management programs also typically utilize health care professionals, such as nurses, to conduct face-to-face meetings or telephone consultations (Caloyeras et al., 2014). Conversely, lifestyle management programs prevent chronic illnesses by: (a) reducing stress; (b) lowering weight; (c) encouraging exercise; (d) promoting smoking cessation; and (e) fostering overall well-being (Caloyeras et al., 2014; Kaspin et al., 2013; Mattke et al., 2013).

 

Wellness Programs

Johnson & Johnson was an early pioneer in the creation and promotion of workplace wellness programs. In the 1970s, the company implemented a wellness program for employees called Live for Life (Ozminkowski et al., 2002). In 1993, this program was modified to integrate the following additional services: (a) employee health; (b) occupational medicine; (c) health promotion; (d) disability management; and (e) an employee assistance program. A modified program was rebranded with a new title: The Johnson & Johnson Health & Wellness Program (Ozminkowski et al., 2002). At the time of the program analysis, Johnson & Johnson employed approximately 40,000 people in the United States, 90% of whom participated in their wellness program. The program was evaluated by comparing outpatient doctor visits, hospital inpatient stays and mental health visits over the course of four years as compared to three years prior to the start of the wellness program. The worksite wellness program resulted in significant annual savings per employee/per year. On average, the study reported $45.17 savings for each outpatient visit, $119.67 per inpatient stays and $70.69 for mental health visits. In sum, Johnson & Johnson reported over $8 million in annual savings (Kaspin et al., 2013; Ozminkowski et al., 2002), creating a model wellness program that has been replicated in other organizations to varying degrees.

In contrast, PepsiCo offered a program in 2004 that did not produce similar results. Over 55,000 employees participated in a 3-year study, and it was determined that while costs were high in the initial year, it was the disease management portion of the program that lowered overall medical expenses by the third year (Liu et al., 2013). The disease management program was six to nine months in length and involved regular phone calls with a nurse for 15 to 25 minutes (Caloyeras et al., 2014). The program focused primarily on conditions such as asthma, coronary artery disease, congestive heart failure, hypertension and strokes (Caloyeras et al., 2014). Conversely, the lifestyle management portion of the program, which focused on weight management, nutrition management, fitness, stress management and smoking cessation, was described simply as involving a “series of telephonic calls with a wellness coach over a six-month period” (Caloyeras et al., 2014, p. 125). Training to become a wellness coach varies widely, ranging from a few days to 6 months. Training typically requires an associate degree and 18 weeks of classes conducted over the telephone or four full days of training in topics that include: (a) growth-promoting relationships; (b) expressing compassion; and (c) eliciting motivation to overcome ambivalence (Wellcoaches, 2016). The lack of sustainable changes in lifestyle wellness programs may be due to the variation and brevity of training for wellness coaches.

Hospitals have started employee wellness programs to lower employee health insurance costs, support mental health, and recruit and retain quality employees (Caloyeras et al., 2014; Hochart & Lang, 2011; Liu et al., 2013; Parkinson et al., 2014). Ironically, while the health care system is designed to help patients achieve good health, it often comes at the price of high stress levels and poor health for the employees (Chang, Hancock, Johnson, Daly, & Jackson, 2005; McClafferty & Brown, 2014; Smith, 2014). In fact, hospital employees tend to exhibit poorer health than other types of employees, which results in hospitals having the highest health care costs among employment sectors in the United States (Parkinson et al., 2014). As a result, some hospitals, such as the University of Pittsburgh Medical Center, are introducing the idea of employee wellness programs. In 2005, the University of Pittsburgh Medical Center utilized a prepackaged wellness program called MyHealth—a program that included both lifestyle and disease management components (Parkinson et al., 2014). Based on the number of requirements an employee met and activities he or she engaged in, the program provided credit that could be used to lower insurance deductibles (Parkinson et al., 2014). MyHealth consisted of online education materials, self-help tools, telephonic health coaching and support groups for lifestyle issues such as smoking cessation, depression, and emotional health and stress issues (Parkinson et al., 2014). Over a 5-year period, overall health care costs were lowered, but again, savings were attributed to the disease management portion of the program and not the lifestyle management portion (Caloyeras et al., 2014). Although there has been moderate success with wellness programs, the inclusion of counselors could make these programs more successful.

 

Need for Counselors in Wellness Programs

Changes in health care and increases in worksite wellness programs have created footholds for trained mental health professionals. As evidenced in the cases above, health care professionals, rather than mental health professionals, are facilitating lifestyle wellness programs. This is unfortunate, as professional counselors are trained in the skills of rapport building, demonstrating empathy and helping others achieve their goals. To build upon counselors’ inherent training and strengths may reduce the need for additional support and behavior change training. Utilizing counselors may result in stronger program implementation and cost savings for companies (Groeneveld, Proper, Absalah, van der Beek, and van Mechelen, 2011). Furthermore, although there have been some promising results and modest savings due to wellness programs, the variability in the content of wellness programs ranges widely. Therefore, it is proposed that having a program designed and led by counselors may have the potential to create larger savings for the lifestyle management portion of worksite wellness programs. With counselors utilizing their skills and coupling these techniques with aspects of motivational interviewing (MI) and the transtheoretical model of change (TTM), they could strengthen the lifestyle management portion of wellness programs and build on the foundation of wellness in counseling. To this end, we propose a psychoeducational lifestyle management conceptual framework that combines both MI and the TTM in an 8-week program, entitled Steps to Better Health (S2BH), which is described in the following section.

 

Components of S2BH

MI is an approach that helps individuals motivate themselves to pursue the changes that they seek. The founders of MI, Miller and Rollnick (2013), defined MI as “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (p. 12). More precisely, MI is about skillfully arranging conversations so that people talk themselves into changing (Miller & Rollnick, 2013). Further, MI has been positively correlated with stress reduction, medication adherence, diet change and exercise participation (Rollnick, Miller, & Butler, 2008). Miller and Rollnick (2013) asserted that people from all backgrounds could be trained to use the tools of MI; however, they emphasize that MI is not simply a collection of techniques (Miller & Rollnick, 2013). Rather, MI should be applied in a context that is characterized by client-counselor collaboration, client independence, and empowering clients to find and use their own resources for change (Young, Gutierrez, & Hagedorn, 2012). In addition to MI, the proposed wellness program integrates the TTM, an evidence-based model for change, and research on effective group work.

The TTM was developed by Prochaska and DiClemente (1982) to facilitate behavioral changes for individuals (Campbell, Eichhorn, Early, Caraccioli, & Greeley, 2012). The TTM consists of five stages of change individuals experience when changing behavior. The five stages are: (a) pre-contemplative (not thinking about change); (b) contemplative (thinking about change); (c) preparation (taking steps to begin change); (d) action (making the change); and (e) maintenance (creating a habit of new change; Shinitzky & Kub, 2001).

Prochaska et al. (2008) reviewed employee health promotion interventions, and results demonstrated that both MI and the TTM individually can lead to effective change. Participants (N = 1400) at a major medical university were assigned to three treatment groups: brief health risk intervention (BHRI) only (n = 433), online TTM-tailored treatment (n = 504), and an MI treatment group (n = 433; Prochaska et al., 2008). The results of the study showed that both the MI and TTM treatment groups had more individuals participating in the action stage for exercise and indicated better management of stress along with less health risk behaviors in 6 months than the BHRI only group (Prochaska et al., 2008). This study suggests that if both MI and TTM are effective separately, then combining them could lead to further success. Additionally, utilizing this combination within the framework of a psychoeducational group for a workplace would create efficiency.

Psychoeducational group work is ideal for a wellness program as it is a “hybrid of an academic course and counseling session” (Brown, 2011, p. 8). This format allows participants to feel as though they are attending a class, which can help them focus on learning and implementing a specific task without the potential stigma of therapy. For working professionals who may not feel the need to participate in traditional counseling, a psychoeducational group provides opportunity for discussions and activities in which individuals can practice various wellness techniques in a safe setting. Additionally, groups can be more cost-effective for businesses and organizations, as a number of individuals can simultaneously accomplish goals in a shared timeframe.

For many wellness programs, the results have been mixed due to expensive training and inadequate application of behavior change principles. For the lifestyle management portion of these wellness programs to be successful, a stronger framework would need to be implemented along with the use of professionally trained counselors. Therefore, a conceptual framework that counselors can consider adapting for a wellness lifestyle management program is proposed. The intention is to emphasize critical theoretical components while integrating practical ideas for counselors to build upon and adapt into their own lifestyle and health management programs.

 

S2BH

     The proposed intervention of S2BH is an 8-week pyschoeducational group that incorporates aspects of both MI and the TTM. Each session consists of a short lesson about a concept related to change followed by a discussion that progressively moves each participant toward making the decision to change and successfully enacting those changes. Devoting 1 hour per week over the span of 8 weeks would yield overall balance and wellness among employees, leading to higher work performance and lower absenteeism (Vitality Institute, 2014). In addition to group sessions, the counselor should be available for optional one-on-one follow-up sessions, up to two times after the initial 8 weeks, ideally at the employer’s expense. These sessions would provide the opportunity for employees to address specific wellness concerns to help maintain changes. For demonstration purposes, below is a brief case example that demonstrates how S2BH could be utilized. In addition, Table 1 contains an overview of the program.

 

Case Illustration

Polly, a 46-year-old oncology nurse for 20 years, and Amelia, a 35-year-old oncology nurse for 9 years, work at Metro Hospital, a 2,000-bed acute care medical facility located in a busy downtown area. Both Polly and Amelia were frustrated about their workloads and felt burned out because of job stressors. They were both interested in joining the S2BH group, as it would give them more points in Metro’s HealthyYou! Campaign. These additional points could later be translated into monetary bonuses to encourage employee participation. After gaining permission from their nurse manager to be part of the S2BH group, both women joined seven other nurses from different floors once a week for an hour during their lunch break. Both Polly and Amelia completed physicals as a part of the campaign, and despite weight and blood pressure issues, neither of the physicals for both women showed severe health concerns.

During their first meeting, Polly shared feeling fatigued and believing that her lack of exercise played a part in that. Amelia stated that though she managed to walk once a week, she still felt lethargic both emotionally and physically, but was not sure why. During this first group, the counselor utilized one of the central principles of MI, which reflects listening skills to express empathy and genuine caring for the nurses. To close the group, everyone received the S2BH Wellness Primer Worksheet as homework.

 

Table 1

Suggested Curriculum for Steps to Better Health

 

Weekly Session

Session Details

Activities in Session

Homework Assigned

Week 1: Rapport Building and Therapeutic Alliance

Counselor will welcome the group and explain the weekly format, with emphasis on goal attainment. Participants will be encouraged to share work-related stressors and wellness goals. A worksheet will be provided for participants to outline wellness goals, steps needed to achieve goals and identification of stressors.

Week 2:

Wellness Education

Participants will explore reasons for change and discuss the homework from the previous session. Participants will discuss potential pitfalls and necessary supports for successful change. Participants will identify what problems they encountered with their last change attempts.

Week 3:

The Stages of Change

Counselor will give lesson on TTM, focusing on the stages of change. Participants will identify which stage of change they are in and work to develop stage-matched interventions. Participants will write down the advantages and disadvantages of achieving their wellness goal(s).

Week 4:

Exploring Ambivalence

Counselor will lead a discussion on ambivalence (Miller & Rollnick, 2013; Shinitzky & Kub, 2001). Participants will discuss benefits and costs of not changing behavior. Each participant will identify one to two new habits as they move toward their wellness goal(s).

Week 5:

Habit Formation

Counselor will discuss how participants can create new habits. Using homework, members will identify cues/routines/rewards for each new habit identified (Duhigg, 2012). Each participant will bring to the next session a brief update on their wellness goal(s).

Week 6:

Reframing & Risk Assessments

Participants will discuss triggers and potential tactics to adhere to personal goals. Participants will identify and isolate potential triggers and solutions for the individual. Participants will identify stressors from work and life that could jeopardize wellness goal(s).

Week 7:

Stress Busters

Participants will discuss stress and ways to enhance coping skills (e.g., emotion-based and action-based). Participants will use homework to identify appropriate coping skills for each stressor. Participants will use one of the identified coping skills over the next week.

Week 8:

Wrap-Up

Participants will discuss how to stay motivated and engaged with wellness plans. Participants will discuss achievements followed by a termination activity. No homework assigned.

 

Polly and Amelia came back to the second group with their S2BH Wellness Primer Worksheet results and were a little hesitant to begin discussing their results. After a few other members shared, Polly stated that the wellness primer made her more aware of her lack of exercise. Amelia then shared that this was the first time she had sat down and reflected on her health and well-being, and though she was not sure it was necessarily helpful, she was willing to try anything to stop feeling “blah.” Following the discussion on the wellness primer, group members worked on developing a wellness plan for the areas they wanted to improve. To close the session, the counselor discussed with the members ways to begin working on their goals in incremental steps and noted different ways they had started addressing those steps.

After learning about the stages of change from the TTM in the third session, Polly was animated about which stage she was on in relation to her goal of exercising more. She shared that she had been stuck on the contemplative stage of change for more years than she could count. She stated that she wanted to lose weight but could not seem to motivate herself to walk before her shift started.

Amelia stated that she wanted to eat better and classified herself as being in the pre-contemplative stage of change. She reported that she needed to eat better because she relied too often on caffeine and sugary foods to keep her going throughout the work day. Several of the group members expressed hope in knowing that they were not just “being lazy,” but were in a process of change. Amelia stated that just knowing that gave her a boost of energy.

After checking in during the fourth session and finding out where everyone was with their goals, the counselor led a discussion on the MI concept of ambivalence. Polly found this a little challenging, as she just wanted to list the pros and cons of her new health goals: exercising and eating better. Once she understood that she was to list both the benefits and costs of continuing her current behavior versus enacting her new health goal, she became more involved in the activity. As a result, Polly listed some pros of walking in the morning as being “it centers me as I release some of the frustration from the day before,” and “I use this time to organize my mind for the upcoming tasks for the day.” Amelia stated that some of her cons for not changing her behavior included “crashing hard around 4 p.m. in the afternoon” and “losing focus when working with patients.”

For the fifth session, a discussion centered around Duhigg’s (2012) book, The Power of Habit: Why We Do What We Do in Life and Business, and how members could apply the principle of cue, reward and routine to help them achieve their goals. Polly stated that she started putting her walking shoes out with her exercise clothes so that she could immediately see them when she woke up (cue). She would play her favorite podcast while walking (routine), and reward herself with a small low-calorie pastry for breakfast (reward). Amelia stated that she started to place almonds and other energy-boosting snacks at the nurses’ station so she could easily see them (cue), then would snack on those items while talking with colleagues (routine). As a result, she felt her energy lasting longer throughout the day (reward).

The nurses enjoyed reframing their previous “relapses” in the sixth session. Amelia reported that she was aware it was normal to move back and forth between the stages and that this knowledge alleviated concerns about failure. The group had a lively discussion about what triggers or pitfalls stood in their way and what places or things they should avoid as a result. For example, Polly stated that if she hit the “snooze button,” she would stay in bed and forgo her walk. Realizing this, she opted to place her alarm clock across the room so that she would have to get out of bed to turn off the alarm.

The seventh session on stressors became more emotional than anticipated as many of the nurses talked about their work and the unique stress they experience when taking care of ill and terminally ill patients. The group members talked about their thoughts and feelings and supported one another during this session. As a result, a spontaneous sharing of how nurses deal with the grief of losing patients occurred. Amelia shared that she had recently decided to join Team in Training for the Leukemia and Lymphoma Society and train for a half marathon in memory of one of her younger patients. She stated that letting the family know and beginning to raise money for research in this area was helping her to positively channel her grief. As a result of this discussion, several of the nurses stated that they left the group with hope, connectivity, and ideas for channeling their grief and stress.

The final session of the group focused on closure. Amelia shared that although she was initially dubious about the group, as a result of her sharing and the small changes she was making with her snacking, she was not feeling as “blah” anymore. Polly also shared that while she had not lost weight yet, she felt more motivated to continue walking and noticed that she felt more positive about walking.

 

Conclusion

Changes in health care have increased job opportunities in health care for counselors. The PPACA allows counselors the opportunity to expand their background of wellness while capitalizing on preventive health care initiatives (Barden, Conley, & Young, 2015; Granello & Witmer, 2013). With the interrelatedness between physical and mental health, counselors are ideally positioned to help clients achieve their wellness goals. Connections between physical activity and psychological well-being are well established, as are the potential benefits of improved coping with stress and adversity (Focht & Lewis, 2013). Because chronic stress has been shown to contribute to obesity and metabolic diseases (Razzoli & Bartolomucci, 2016), helping employees improve their coping skills can lead to adaptive ways of dealing with stress, which ultimately impacts chronic health conditions. To better manage occupational stress, counselors can fill the need for bringing stress management skills to the workplace (Galla et al., 2015).

In addition, wellness programs provide the ability for counselors to research their contributions to workplace wellness programs, thereby providing an opportunity to study counselor effectiveness. Research has shown that using health care professionals in disease management portions of wellness programs can lower costs. The focus of this manuscript has been to describe a framework for counselors to facilitate lifestyle management programs in corporate settings. Considerable sponsored research opportunities also are available, especially for worksite wellness programs targeted to underserved populations (U.S. Department of Health and Human Services Office of Minority Health, 2016).

 

 

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest

or funding contributions for the development

of this manuscript.

 

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Yvette Saliba, NCC, is a doctoral student at the University of Central Florida. Sejal Barden, NCC, is an Associate Professor at the University of Central Florida. Correspondence can be addressed to Yvette Saliba, 851 South State Road 434, Suite #1070-170, Altamonte Springs, FL 32714, ysaliba@knights.ucf.edu.